An outside expert will examine overcrowding at the Oregon State Hospital that’s caused the state’s largest psychiatric facility to turn away certain patients until beds opened up.
Under a settlement reached Friday, a medical and behavioral health leader from Michigan’s state health agency will conduct a review of the Oregon hospital and offer recommendations to get the state back into compliance with earlier court orders that mandate speedy admissions. The state has delayed admissions for nearly two years because of the coronavirus pandemic.
The state entered into a settlement with the advocacy group Disability Rights Oregon and Metropolitan Public Defenders, requiring the psychiatric hospital to undergo a review from an outside expert to address the delayed admissions process the hospital has been using for nearly two years.
The advocacy group Disability Rights Oregon and Metropolitan Public Defenders, which sued the state over the delays, said they hope the review will be a major step in revising Oregon’s troubled behavioral health system, which has struggled to accommodate patients in both institutional and community care settings.
Under a 2002 court order, the hospital must admit patients accused of crimes but found unable to aid in their own defense within seven days of those findings. But early in the pandemic, a federal judge paused that order so the hospital could limit the spread of COVID-19 and quarantine patients. Mental health advocates have criticized the hospitals’s delays, saying it violates “aid and assist” patients’ constitutional rights.
Emily Cooper, the legal director for Disability Rights Oregon, said her organization began working with the state on the agreement in October, two months before the court order that allowed the delays was set to expire.
“This is an example of where we should be working together to solve problems, not fighting about whether the problem exists,” she said.
In a written statement Friday, Oregon Health Authority Director Patrick Allen said he was encouraged by the agreement and hoped that it would help get more people into the state hospital in a reasonable amount of time.
“We all want to decriminalize mental illness in Oregon and give people who are seriously mentally ill treatment in a hospital bed, not confinement in a jail cell if they haven’t committed a serious crime,” Allen said. “The Oregon State Hospital can’t solve its capacity crisis alone.”
The state hospital has faced a series of problems during the pandemic, including increased complaints from staff and patients about assaults and discrimination, as well as an employee shortage that led the state to call in the National Guard twice over the summer to staff the hospital.
Under the new agreement, the hospital will undergo a review from Dr. Debra Pinals, the medical director for behavioral health and forensic programs at the Michigan Department of Health and Human Services. Pinals will file a report by Jan. 31, making some short-term recommendations to get the hospital in compliance with its admissions order.
By April 29, Pinals must provide long-term recommendations. If the parties agree with the recommendation, the Oregon Health Authority will implement the plan and will make progress monthly reports to Pinals.
Cooper said she hopes the short-term recommendations will include plans to fund diversion and behavioral health services right away. That, she said, would help keep people out of jail and the hospital in the first place.
In the long-term, she said, she hopes the review will look at possible solutions for expanding community housing for mental health patients.
Cooper said Pinals has already begun interviewing state employees and is reviewing documents and records related to the hospital’s capacity problems.
She said Pinals was selected to do the review because of her record leading Michigan’s state behavioral health services.
“They have no waitlist. The state hospital has not called the National Guard. They are not under federal scrutiny,” Cooper said. “This is someone who, in a practical way, has been able to provide timely services to people in her state. We hope she can lead us to a similar result in our state.”
The court agreement also stipulates that plaintiffs in the 20-year-old court order at the root of the admissions requirements will not sue the hospital during this time, allowing the hospital a grace period for complying with admissions requirements.
—Jayati Ramakrishnan